The dacryocyst, often called the lacrimal sac, is a part of the eye’s tear drainage system. Located near the inner corner of the eye, nestled in a bony hollow, its primary role is collecting tears before they drain into the nasal cavity, acting as a temporary reservoir to manage tear flow away from the eye’s surface.
Understanding the Dacryocyst
Tears are produced by the lacrimal glands, situated above the outer corner of each eye. These tears spread across the eye’s surface with each blink, providing lubrication and washing away debris. Tears gather at the inner corner of the eye and enter two tiny openings, the lacrimal puncta.
From the puncta, tears flow into small channels, the canaliculi, which lead into the dacryocyst. From the dacryocyst, tears proceed down a tube called the nasolacrimal duct. This duct empties into the nasal cavity, allowing tears to drain.
Common Problems Affecting the Dacryocyst
Dacryocystitis is inflammation of the lacrimal sac. This condition arises from a blockage in the nasolacrimal duct, leading to a buildup of tears and fluid within the dacryocyst. Bacterial infections are a frequent cause, as trapped fluid provides an environment for microbial growth. Trauma or the natural aging process can also contribute to this inflammation.
Nasolacrimal duct obstruction is another problem, where the tear duct becomes blocked and prevents drainage. This blockage can be congenital (meaning a baby is born with an underdeveloped or closed duct) or develop later due to inflammation, injury, or narrowing of the duct. Both dacryocystitis and nasolacrimal duct obstruction can cause symptoms. Individuals often experience excessive tearing, known as epiphora, as tears cannot drain effectively and overflow. Other signs may include redness, tenderness, and swelling around the inner corner of the eye. Mucus or pus-like discharge may be present, particularly if an infection is involved.
Diagnosing Dacryocyst Conditions
Conditions affecting the dacryocyst are diagnosed through physical examination and specific tests. The examination involves observing the eye and the area around the lacrimal sac for signs such as swelling, redness, or tenderness. The doctor also inquires about the duration and nature of symptoms, including the frequency of excessive tearing or discharge.
A common diagnostic tool is the fluorescein dye disappearance test. A small amount of orange dye is placed in the eye. The time it takes for the dye to drain is observed; delayed disappearance suggests a drainage issue. Another procedure, lacrimal irrigation, involves flushing saline solution through the tear drainage system using a tube inserted into the puncta. If the solution does not flow into the nasal cavity, it indicates a blockage within the dacryocyst or nasolacrimal duct.
Treatment Approaches
Treatment for dacryocyst-related conditions varies depending on the underlying cause and symptom severity. For infections like dacryocystitis, oral antibiotics are prescribed to clear bacterial presence within the lacrimal sac. Warm compresses applied to the affected area can help reduce inflammation and discomfort. Gentle massage over the lacrimal sac may be recommended to encourage drainage.
Topical eye drops, sometimes containing antibiotics, can manage eye irritation or conjunctivitis. For nasolacrimal duct obstruction, particularly in infants, doctors often suggest repeated massage over the lacrimal sac to encourage the duct’s opening. If non-surgical methods prove ineffective or the blockage is persistent, surgical intervention may be considered. Dacryocystorhinostomy (DCR) is a common surgical procedure. It creates a new pathway for tears to drain from the dacryocyst into the nasal cavity, bypassing the obstruction. This procedure aims to restore normal tear flow and alleviate symptoms associated with drainage issues.